tetano
Editor, Senior Moderator
J Cardiol
. 2022 May 16;S0914-5087(22)00101-0.
doi: 10.1016/j.jjcc.2022.04.010. Online ahead of print.
Incidence and predictors of cardiac arrhythmias in patients with COVID-19 induced ARDS
Philipp Niehues[SUP] 1 [/SUP], Felix K Wegner[SUP] 2 [/SUP], Julian Wolfes[SUP] 1 [/SUP], Kevin Willy[SUP] 1 [/SUP], Christian Ellermann[SUP] 1 [/SUP], Richard Vollenberg[SUP] 3 [/SUP], Holger Reinecke[SUP] 4 [/SUP], Felix Rosenow[SUP] 4 [/SUP], Johannes Lepper[SUP] 4 [/SUP], Jan Sackarnd[SUP] 4 [/SUP], Lars Eckardt[SUP] 1 [/SUP]
Affiliations
Abstract
Introduction: Recent studies suggest cardiac involvement with an increased incidence of arrhythmias in the setting of coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the risk of potentially lethal arrhythmias and atrial fibrillation in patients with COVID-19-induced acute respiratory distress syndrome (ARDS) and to elicit possible predictors of arrhythmia occurrence.
Methods and results: A total of 107 patients (82 male, mean age 60 ± 12 years, median body mass index 28 kg/m[SUP]2[/SUP]) treated for COVID-19-induced ARDS in a large tertiary university hospital intensive care unit between March 2020 and February 2021 were retrospectively analyzed. Eighty-four patients (79%) had at least moderate ARDS, 88 patients (83%) were mechanically ventilated, 35 patients (33%) received vvECMO. Forty-three patients (40%) died during their hospital stay. Twelve patients (11%) showed potentially lethal arrhythmias (six ventricular tachycardia, six significant bradycardia). Atrial fibrillation occurred in 27 patients (25%). In a multivariate logistic regression analysis, duration of hospitalization was associated with the occurrence of potentially lethal arrhythmias (p = 0.006). There was no association between possible predictive factors and the occurrence of atrial fibrillation. Invasive ventilation, antipsychotics, and the QT[SUB]c[/SUB] interval were independently associated with acute in-hospital mortality, but this was not arrhythmia-driven as there was no association between the occurrence of arrhythmias and mortality.
Conclusion: In this relatively young population with COVID-19-induced ARDS, the incidence of potentially lethal arrhythmias was low. While overall mortality was high in these severely affected patients, cardiac involvement and arrhythmia occurrence was not a significant driver of mortality.
Keywords: Acute respiratory distress syndrome; Arrhythmia; Atrioventricular block; Coronavirus disease 2019; Ventricular tachycardia.
. 2022 May 16;S0914-5087(22)00101-0.
doi: 10.1016/j.jjcc.2022.04.010. Online ahead of print.
Incidence and predictors of cardiac arrhythmias in patients with COVID-19 induced ARDS
Philipp Niehues[SUP] 1 [/SUP], Felix K Wegner[SUP] 2 [/SUP], Julian Wolfes[SUP] 1 [/SUP], Kevin Willy[SUP] 1 [/SUP], Christian Ellermann[SUP] 1 [/SUP], Richard Vollenberg[SUP] 3 [/SUP], Holger Reinecke[SUP] 4 [/SUP], Felix Rosenow[SUP] 4 [/SUP], Johannes Lepper[SUP] 4 [/SUP], Jan Sackarnd[SUP] 4 [/SUP], Lars Eckardt[SUP] 1 [/SUP]
Affiliations
- PMID: 35589465
- DOI: 10.1016/j.jjcc.2022.04.010
Abstract
Introduction: Recent studies suggest cardiac involvement with an increased incidence of arrhythmias in the setting of coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the risk of potentially lethal arrhythmias and atrial fibrillation in patients with COVID-19-induced acute respiratory distress syndrome (ARDS) and to elicit possible predictors of arrhythmia occurrence.
Methods and results: A total of 107 patients (82 male, mean age 60 ± 12 years, median body mass index 28 kg/m[SUP]2[/SUP]) treated for COVID-19-induced ARDS in a large tertiary university hospital intensive care unit between March 2020 and February 2021 were retrospectively analyzed. Eighty-four patients (79%) had at least moderate ARDS, 88 patients (83%) were mechanically ventilated, 35 patients (33%) received vvECMO. Forty-three patients (40%) died during their hospital stay. Twelve patients (11%) showed potentially lethal arrhythmias (six ventricular tachycardia, six significant bradycardia). Atrial fibrillation occurred in 27 patients (25%). In a multivariate logistic regression analysis, duration of hospitalization was associated with the occurrence of potentially lethal arrhythmias (p = 0.006). There was no association between possible predictive factors and the occurrence of atrial fibrillation. Invasive ventilation, antipsychotics, and the QT[SUB]c[/SUB] interval were independently associated with acute in-hospital mortality, but this was not arrhythmia-driven as there was no association between the occurrence of arrhythmias and mortality.
Conclusion: In this relatively young population with COVID-19-induced ARDS, the incidence of potentially lethal arrhythmias was low. While overall mortality was high in these severely affected patients, cardiac involvement and arrhythmia occurrence was not a significant driver of mortality.
Keywords: Acute respiratory distress syndrome; Arrhythmia; Atrioventricular block; Coronavirus disease 2019; Ventricular tachycardia.